作者：周云,高山钟,关敬树,王文惠

单位：

1.201999 上海市宝山区中西医结合医院心内科 2.201999 上海市宝山区中西医结合医院检验科 通信作者：周云，E-mail：lixiuqinys@163.com

Units：

1.Department of Cardiology, Shanghai Baoshan Integrated Chinese and Western Medicine Hospital, Shanghai 201999, China 2.Department of Cinical Laboratory, Shanghai Baoshan Integrated Chinese and Western Medicine Hospital, Shanghai 201999,China Corresponding author: ZHOU Yun, E-mail: lixiuqinys@163.com

关键词：

心力衰竭; 室性早搏复合征; 同型半胱氨酸; 胆红素; 相关性;

Keywords：

Heart failure; Ventricular premature complexes; Homocysteine; Bilirubin; Correlation

CLC：

DOI：

10.12114/j.issn.1008-5971.2021.00.269

Funds：

摘要：

背景血清同型半胱氨酸(Hcy)水平升高提示心血管疾病发生风险升高。心力衰竭患者较易并发肝功能损伤,推测该类患者发生室性期前收缩可能与肝功能损伤有关,而胆红素是反映肝功能的代表性指标之一。目的分析慢性心力衰竭伴早期室性期前收缩患者血清Hcy、胆红素水平及其意义。方法 回顾性选取上海市宝山区中西医结合医院2017年6月至2019年6月收治的慢性心力衰竭患者200例,根据早期室性期前收缩发生情况分为A组98例(发生早期室性期前收缩)和B组102例(未发生早期室性期前收缩),另选取同期于本院体检的健康者50例作为对照组。比较三组受试者的一般资料、实验室检查指标,并记录A组患者24 h室性期前收缩次数。采用Pearson相关分析探讨血清Hcy、直接胆红素、总胆红素水平与慢性心力衰竭伴早期室性期前收缩患者24 h室性期前收缩次数的相关性。结果 三组受试者性别、年龄、体质指数及有吸烟史、饮酒史者所占比例比较,差异无统计学意义(P>0.05)。A、B组患者血清Hcy、直接胆红素、总胆红素、N末端脑钠肽前体(NT-proBNP)、肌酸激酶同工酶(CK-MB)水平高于对照组(P <0.05);A组患者血清Hcy、直接胆红素、总胆红素、NT-proBNP、CK-MB水平高于B组(P <0.05)。A组患者24 h室性期前收缩次数为(2 246±84)次。Pearson相关分析结果显示,慢性心力衰竭伴早期室性期前收缩患者24 h室性期前收缩次数与血清Hcy(r=0.796)、直接胆红素(r=0.801)、总胆红素(r=0.831)水平均呈正相关(P <0.001),与血清NT-proBNP(r=0.452)、CK-MB(r=0.178)水平无直线相关关系(P>0.05)。结论 慢性心力衰竭伴早期室性期前收缩患者血清Hcy、直接胆红素、总胆红素水平较高,且其与24 h室性期前收缩次数呈正相关。

Abstract：

【Abstract】　Background The elevated level of serum homocysteine (Hcy) suggests an increased risk of cardiovasculardisease. Patients with heart failure is more likely to be complicated with liver function damage. It is speculated that ventricularextrasystole in these patients may be related to liver function damage, and bilirubin is one of the representative indexes reflectingliver function. Objective To investigate the serum Hcy and bilirubin levels and their significance in chronic heart failure patientscomplicated with early ventricular premature contraction.Methods A total of 200 patients with chronic heart failure who wereadmitted to Shanghai Baoshan Integrated Chinese and Western Medicine Hospital from June 2017 to June 2019 were selectedretrospectively. According to the occurrence of early ventricular premature contraction, they were divided into group A (with earlyventricular premature contraction, n=98) and group B (without early ventricular premature contraction, n=102) . In addition, 50healthy subjects who underwent physical examination in the same hospital during the same period were selected as control group.General information, laboratory examination indexes were compared among the three groups, and the number of 24 h ventricularpremature contraction of group A were recorded. Pearson correlation analysis was used to explore the correlation between serumHcy, direct bilirubin and total bilirubin levels and the number of 24 h ventricular premature contraction in chronic heart failurepatients complicated with early ventricular premature contraction. Results There was no statistically significant difference ingender, age, body mass index and proportion of smoking and drinking history among the three groups (P > 0.05) . Serum levelsof Hcy, direct bilirubin, total bilirubin, N-terminal pro-brain natriuretic peptide (NT-proBNP) and creatine kinase isoenzyme(CK-MB) in group A and group B were higher than those in control group (P < 0.05) ; serum levels of Hcy, direct bilirubin,total bilirubin, NT-proBNP and CK-MB in group A were higher than those in group B (P < 0.05) . Number of 24 h ventricularpremature contraction of group A was (2 246±84) times. Pearson correlation analysis results showed that, number of 24 hventricular premature contraction of chronic heart failure patients complicated with early ventricular premature contraction waspositively correlated with serum levels of Hcy (r=0.796) , direct bilirubin (r=0.801) and total bilirubin (r=0.831) (P < 0.001) ,and had no linear correlation with serum levels of NT-proBNP (r=0.452) , CK-MB (r=0.178) (P > 0.05) .ConclusionThelevels of serum Hcy, direct bilirubin and total bilirubin in chronic heart failure patients complicated with early ventricularpremature contraction are higher, and they are positively correlated with the number of 24 h ventricular premature contraction.

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